Parotid gland swelling in association with general anesthesia is an unusual complication. Benign postoperative parotid swelling should be recognized as a noninfectious, self-limiting process occurring immediately after surgery. This enlargement is non-tender, rubbery in consistency, without crepitus, and may be accompanied by variable salivation. The mechanism of the occurrence remains unknown, but two factors most frequently associated with this phenomenon appear to be physical stimulation or manipulation of the airway or coughing and/or straining. We report bilateral parotid gland swelling in a middle-aged man after surgery under general anesthesia.
Anesthesia, General* ; Cough ; Parotid Gland* ; Physical Stimulation ; Salivation

Here, we report the poisoning case of 10 cows. Several distinct clinical signs such as convulsion, excessive salivation, circling, lateral recumbency, and death were observed. Necropsy and histopathological examination did not reveal any significant abnormal findings. Moreover, no bacteria or viruses were detected in tissue, blood, and feeding food. However, endosulfan was detected from the stomach contents and microbials. Our results strongly suggest that death of cows may be closely associated with endosulfan poisoning.
Animals ; Bacteria ; Cattle* ; Endosulfan* ; Gastrointestinal Contents ; Poisoning* ; Salivation ; Seizures

OBJECTIVES: Daytime drowsiness or sedation and changes in night sleep are commonly seen in patients treated with clozapine. There is, however, very limited informatio on their degree and nature during the course of treatment. The purpose of this study was to understand the sleep patterns in chronic schizophrenic patients with clozapine treatment over a period of 24 weeks. METHOD: The sleep pattern was evaluated using a set of 5-point scale questionnaire, to record subjective impressions of the night sleep induction, maintenance and quality, and daytime drowsiness and fatigue. In addition, unusual experiences associated with night sleep were recorded. The sleep questionnaire was repeatedly administered at baseline and at 1, 2, 4, 8, 12 and 24 weeks of drug treatment. At present, data on 12 patients has been collected. RESULTS: All the components of night sleep were significantly improved in th 1st through the 12 th week after treatment with clozapine. Daytime drowsiness was significantly higher in the 1st to the 2nd week after the treatment and fatigue was also significantly higher in the 1st to the 4th week after the treatment. Eight patients experienced noticeable increases in salivation during night sleep, and of these, one also reported frequent nocturnal urination and even enuresis. However, all these adverse factors did not affect the major sleep patterns. CONCLUSIONS: These finding suggest that the beneficial effects of clozapine on night sleep might last much longer than the undesirable effect of daytime drowsiness and fatigue. In other words, tolerance of the hypnotic action of clozapine might develop late and tolerance of the daytime drowsiness and fatigue might be evident earlier.
Clozapine* ; Enuresis ; Fatigue ; Humans ; Surveys and Questionnaires ; Salivation ; Sleep Stages ; Urination

Gastroesophageal reflux disease (GERD) and sleep disturbances are both common health problems. There is a significant association between disturbed sleep and GERD, and this may be bidirectional. Sleep disorders may induce gastrointestinal (GI) disturbances, while GI symptoms also may provoke or worsen sleep derangements. Reflux of gastric acid is a less frequent event during sleep, however, acid clearance mechanisms (including swallowing, salivation and primary esophageal motility) are impaired during sleep resulting in prolongation of acid contact time. Nighttime reflux can lead to sleep disturbance and sleep disturbance may further aggravate GERD by prolonged acid contact time and heightened sensory perception. This may facilitate the occurrence of complicated GERD and decreased quality of life. However, the interplay between sleep problems and GERD is complex, and there are still relatively limited data on this issue. Further investigation of sleep-related GERD may identify common pathophysiological themes and new therapeutic targets.
Aluminum Hydroxide ; Carbonates ; Deglutition ; Gastric Acid ; Gastroesophageal Reflux ; Quality of Life ; Salivation ; Sleep Wake Disorders

Tri- and tetra-cyclic antidepressants are known to cause dry mouth among other several major complications. The present study was designed to compare the degree of reduced salivation due to antidepressants and to explore whether intracellular calcium-increasing agents ameliorate the salivation. Effects of antidepressants and agents increasing intracellular calcium on the cholinergic submandibular secretion and blood flow induced by the chorda stimulation or intra-arterial acetylcholine were observed in anesthetized cats. Effects of antidepressants and calcium-mobilizing agents on K+ efflux were also observed in excised gland slices. The results obtained were as follows: 1. Salivary secretion in response to the chorda stimulation (3 V, 20 Hz, 1 msec) was significantly attenuated by antidepressants in a dose-dependent manner, whereas the blood flow was not affected. 2. Salivary secretion and increased blood flow evoked by intra-arterial acetylcholine (20 microgram/kg) were markedly diminished by antidepressants, the magnitude of which was amitryptyline>imipramine >mianserin in order. 3. Cholinergic salivation was significantly decrease by cyclopiazonic acid, a calcium pump inhibitor of the endoplasmic reticulum, or by BAPTA/AM, a specific intracellular calcium chelator. 4. Caffeine and ryanodine potentiated the cholinergic salivation and ameliorated the depressed salivary secreation due to antidepressants. 5. Calcium ionophore A 23187 ameliorated the depressed salivation due to antidepressants. 6. Antidepressants inhibited the K+ efflux, which were restored by caffeine or A 23187. These results suggest that the depressed salivary secreation due to antidepressants is ameliorated by increasing intracellular calcium levels.
Acetylcholine ; Animals ; Antidepressive Agents ; Caffeine ; Calcimycin ; Calcium* ; Cats ; Endoplasmic Reticulum ; Mouth ; Ryanodine ; Salivation*

PURPOSE: The purpose of this study was to investigate effects of Oral Function Improvement Exercises on salivation, xerostomia and halitosis in elderly people. METHODS: The participants in the study were 48 female community-dwelling elders in D city. The Oral Function Improvement Exercises were given 3 times a week, for a total of 24 times from August to October 2011. Spitting method, Visual Analogue Scale, and halimeter (mBA-21) were used to evaluate the effects of Oral Function Improvement Exercises on salivation, xerostomia, and halitosis. The data were analyzed using chi2-test and t-test with the SPSS program. RESULTS: The experimental group had significantly better salivation, and less xerostomia and halitosis than the control group. CONCLUSION: The results indicate that Oral Function Improvement Exercises were effective for salivation, xerostomia and halitosis in the elders. Therefore, it was suggested that Oral Function Improvement Exercise are applicable in a community nursing intervention program to improve the quality of life for elders.
Aged ; *Exercise ; Female ; Halitosis/*physiopathology ; Humans ; Program Evaluation ; Quality of Life ; Questionnaires ; Salivation/*physiology ; Xerostomia/*physiopathology

Muscarinic acetylcholine receptors (mAChRs), including M1-M5 subtypes, are classic receptors in regulating water, ion, and solute transport in salivary gland. Our work focuses on the studies on the expression pattern and function of mAChR in the submandibular gland (SMG), and the underlying mechanism involved in the mAChR-regulated secretion, together with the effect of parasympathectomy on the salivary secretion. Microvascular autotransplantation of SMG into the temporal fossa provides a continuous and endogenous source of fluids, and is currently an effective method for treating severe keratoconjunctivitis sicca. By using RT-PCR, Western blotting, and immunofluorescence, our data demonstrated that the expression of M1 and M3 subtypes were decreased in latent period in rabbit SMG autotransplantation model, whereas carbachol stimulation promoted the salivary secretion, as well as M1 and M3 expressions. By contrast, mAChRs were hypersensitive in epiphora SMGs, whereas atropine gel and botulinum toxin A application significantly inhibited the hypersecretion in both animal models and patients. Furthermore, the possible intracellular signal molecules involved in the mAChR-modulated salivary secretion were explored. Activation of mAChR upregulated the expression of aquaporin 5 (AQP5), the main transporter that mediated water secretion through transcellular pathway, and led to AQP5 trafficking from lipid rafts to non-lipid microdomain. Extracellular signal-regulated kinase 1/2 (ERK1/2) was involved in the mAChR-regulated AQP5 content. mAChR activation also modulated the expression, distribution, and function of tight junction proteins, and increased paracellular permeability. ERK1/2/β-arrestin2/clathrin/ubiquitin signaling pathway was responsible for the mAChR-regulated downregulation of tight junction molecule claudin-4. Cytoskeleton filamentous actin (F-actin) was also involved in the distribution and barrier function of epithelial tight junctions. Besides, endothelial tight junctions were opened by mAChR agonist-evoked salivation in the mice. Furthermore, parasympathetic denervation increased resting salivary secretion in the long terminrats and minipigs. Taken together, our work demonstrated that mAChR regulated saliva secretion via transcellular and paracellular pathways in SMG epithelium as well as tight junction opening in SMG endothelium. Modulation of mAChR might be a promising strategy to ameliorate SMG dysfunction.
Animals ; Aquaporin 5 ; Carbachol ; Humans ; Mice ; Rabbits ; Receptors, Muscarinic ; Salivation ; Submandibular Gland

Organophosphate fungicides include edifenphos, iprobenfos and tolclofos-methyl. Edifenphos inhibits cell wall synthesis by reduction in chitin synthase activity and inhibits the action of acetylcholinesterase. Thus, exposure to this chemical results in excessive salivation, lacrimation, urination, defecation, gastrointestinal motility and emesis symptoms, just like other organophosphate insecticides. Although edifenphos is an organophosphate fungicide, it is the only agricultural chemical which inhibits the action of pralidoxime and atropine, an activity which in turn, inhibits treatment. Thus, we have to treat these cases as soon as possible with atropine and pralidoxime, using the same approach as used for exposure to other organophosphate insecticides. In this report we evaluate the results of treatment of 4 patients who were intoxicated by fungicides (3 cases with edifenphos and 1 case with iprobenfos).
Acetylcholinesterase ; Atropine ; Cell Wall ; Chitin Synthase ; Defecation ; Gastrointestinal Motility ; Humans ; Insecticides ; Organothiophosphorus Compounds ; Pralidoxime Compounds ; Salivation ; Urination ; Vomiting

Purpose: Acute organophosphate (OP) poisoning may be monitored by measuring the acetylcholinesterase (AChE). It is important to assess severity and establish prognostic tests in the early stage of OP poisoning. The aim of this study was to look at the relationship between various clinical aspects of the OP poisoning, prognostic indicators of OP poisoning including Simplified Acute Physiology Score (SAPS) 3, and the associated changes in AChE levels. Methods: Clinical data and initial AChE levels from thirty-seven patients with OP poisoning were prospectively reviewed from 12 teaching hospitals in South Korea from August 2005 to July 2006. Clinical manifestations at the time of arrival such as miosis, respiratory abnormality, salivation, urinary incontinence, GCS score, AVPU scale, need for intubation, and mechanical ventilation requirements were recorded. SAPS 3 was calculated using clinical data and laboratory results. Results: The median level of AChE was 9.8 (1.3-53.6) U/gHb. There was no significant difference in AChE levels between the groups with and without cholinergic symptoms. The median level of AChE of the patients who required intubation and those who did not were 3.5 U/gHb and it 19.7 U/gHb respectively (Mann-Whitney test; p<0.001). The AChE levels were also significantly different (p=0.007) in patients who needed mechanical ventilation compared to those who did not with AChE levels found to be 3.1 U/gHb and it was 14.8 U/gHb, respectively. Level of consciousness assessed using the AVPU scale was correlated with AChE levels (Kruskal-Wallis test; p=0.013). GCS score were correlated with AChE levels (p=0.007, Spearman's rho = 0.454). In addition, the lower the level of initial AChE, the longer the ICU stay (p=0.029, Spearman's rho=-0.380). SAPS 3 was inversely correlated with the initial AChE (p<0.001, Spearman's rho=-0.633). Conclusion: In the acute OP poisoning, low AChE levels appear to help indicate the severity of poisoning. The initial AChE level may be a useful prognostic parameter for acute OP poisoning.
Acetylcholinesterase ; Consciousness ; Hospitals, Teaching ; Humans ; Intubation ; Miosis ; Organophosphate Poisoning ; Prognosis ; Prospective Studies ; Republic of Korea ; Respiration, Artificial ; Salivation ; Urinary Incontinence

PURPOSE: The aim of this study is to develop a salivation stimulation method and to verify the effect of a salivation stimulation method on xerostomia in colon cancer patients after surgery. METHODS: This study targeted 21 in the experimental group and 22 in the control group, who were diagnosed with colon cancer and underwent surgery at A university hospital. The salivation stimulation method consists of tongue movement for stimulating minor salivary glands in mouth and a parotid gland and submandibular gland massage with hands. The method was applied four times a day for 2 days the next day after surgery. RESULTS: On the first postoperative day, the experimental group showed a significantly larger amount of salivation than the control group (p=.010). On the second postoperative day, the experimental group showed a significantly larger amount of salivation than the control group (p<.001). On the first postoperative day, the subjective xerostomia scores in the experimental group and control group were not statistically significant (p=.165). On the second postoperative day, the experimental group showed a significantly lower subjective xerostomia score than the control group (p=.001). CONCLUSION: It is considered that providing cancer patients with this salivation stimulation method after surgery would reduce discomfort caused by xerostomia.
Colon* ; Colonic Neoplasms* ; Hand ; Humans ; Massage ; Methods* ; Mouth ; Parotid Gland ; Salivary Glands, Minor ; Salivation* ; Submandibular Gland ; Tongue ; Xerostomia*